Yet more benefits benefits from the epidural

An indirect benefit of an epidural is that of removing the need to use any other drugs for pain. There is always concern that the injected drugs inevitably reach the baby and may have various effects on him or her.

The drugs (local anesthetics) used in an epidural have no direct effects on the baby.

Epidural and the lowering of blood pressure

Epidural analgesia lowers the blood pressure but this is never a serious problem. The infusion given just before inserting the epidural is usually an adequate measure against excessive blood pressure drop. Even if the blood pressure fall was found to be severe enough to require further action (which is very rare), an injection of a common and safe drug Ephedrine quickly and effectively reverses this effect.

Where an epidural should not be used

Some heart conditions are considered a contraindication to using epidural analgesia. These include aortic stenosis. This is a condition where the valve that leads from the heart to the artery known as the aorta is narrowed.

Pulmonary hypertension is another condition where an epidural should not be used. In this condition, the blood pressure in the arteries supplying the lungs is abnormally high.

In these cases, such patients are usually delivered by cesarean section and therefore pain relief in labor is not an issue.

Another situation where epidural may not be recommended is current use of anticoagulant medication such as warfarin. This is because of a theoretical increase in the risk of bleeding. In any case, it is very unlikely that a pregnant woman would be on warfarin. However, use of low molecular weight heparins (LMWH) is relatively more common in pregnancy.

An epidural is also contraindicated in the presence of an infection in the vicinity of the injection site, such as an abscess, or even in the case of a systemic infection such as septicemia.

The most obvious contraindication to an epidural is maternal wishes NOT to have one.

Oral pain relief in labor

There are no oral drugs for pain relief in labor. The reason is simple: They would not work because absorption from the stomach during labor is patchy at best.

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